Calcaneal Ultrasonometry: Response to Treatment in Comparison with Dual X-ray Absorptiometry Measurements of the Lumbar Spine and Femur |
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Authors: | L Rosenthall J Caminis A Tenehouse |
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Institution: | (1) The Montreal General Hospital, McGill University, 1650 Cedar Ave., Montreal, Canada H3G 1A4, CA |
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Abstract: | The object of this study was to determine the effectiveness of calcaneal ultrasonometry in the prediction of bone mineral
changes in the lumbar spine and femoral neck in response to treatment of osteoporosis. There were 673 women in the study who
had one or more follow-up measurements between 1 and 4 years after the initial baseline determination for a total of 881 same-day
measurements of the calcaneus, spine, and femur. The LUNAR Achilles and LUNAR DPX (LUNAR Corporation, Madison, WI) were used.
Patients were divided into three treatment time groups: Group 1, 1–<2 years, n = 461; Group 2, 2–<3 years, n = 278; Group
3, 3–<4 years, n = 142. There were significant increases in the bone mineral density (BMD) of the lumbar spine, femoral neck,
and in the broadband ultrasonic attenuation (BUA) of the calcaneus for the three groups. In contrast, a significant decrease
in speed of sound (SOS) was obtained in these time frames and the stiffness index remained unchanged. Spearmen correlations
showed an inverse relationship between the percent changes in SOS and BUA, the reasons for which are speculative. Correlations
between the percent changes in calcaneal parameters and the BMDs of the lumbar spine and femoral neck were weak, whether significant
or not, rho varying from −0.12 to 0.20. There was a subset of 371 patient measurements that registered BMD increases in both
the lumbar spine and femoral neck. This was considered to be an objective indication of adequate compliance with prescribed
treatment. Analysis of this subset yielded parameter correlations similar to those of the entire group. It is concluded that
changes in the calcaneal ultrasound parameters in response to treatment of osteoporosis are not a reflection of mineral changes
occurring in the lumbar spine and femoral neck in a given individual, and in this regard, calcaneal ultrasonometry is not
a substitute for direct-site dual X-ray absorptiometry (DXA) measurement of the lumbar spine and femur.
Received: 19 February 1998 / Accepted: 24 June 1998 |
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Keywords: | : Ultrasonometry — Calcaneus — Treatment — Response — Bone mineral density |
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